Liver problems after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 197 reports of liver problems in dogs after Imidacloprid + Moxidectin. That is 1.5% of all reports for this medicine, compared with 4.6% across reports for all dog medicines, so it is reported less often than average with this medicine.

197Reports

78%Marked serious

21%Recovered

20%Died or euthanised

12 daysTypical onset

How soon it started

Same day

21 18%

1–2 days

18 15%

3–7 days

20 17%

1–4 weeks

27 23%

Over a month

32 27%

How the animals did

Recovered

39 20%

Recovered with lasting effects

3 1.5%

Still unwell when reported

21 11%

Died

22 11%

Euthanised

18 9.1%

Not known

94 48%

Problems reported at the same time

83 42%

68 35%

51 26%

39 20%

38 19%

28 14%

27 14%

25 13%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Imidacloprid kills fleas (spot-on or collar). Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs).

Products with this combination include Advantage Multi. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Questions owners ask

Can Imidacloprid + Moxidectin cause liver problems in dogs?: 197 reports link the two, but a report alone does not prove the medicine was the cause: other illnesses, other medicines or coincidence can be involved. Your vet can judge it for your animal.
How soon after a dose was it reported?: In half of the reports with dates, it started within 12 days of the first dose.
What should I do?: Don't give another dose until you've spoken to your vet, and keep the packaging so you can tell them the product and dose. Your vet can also report it to the FDA (or you can, through the manufacturer or FDA form 1932a).

Liver problems with similar medicines

Liver problems after Spinosad (Comfortis) 955 reports · 1.7% of its reports
Liver problems after Lufenuron + Milbemycin Oxime (Sentinel) 414 reports · 1.6% of its reports
Liver problems after Nitenpyram (Capstar) 87 reports · 0.8% of its reports
Liver problems after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 132 reports · 1.3% of its reports
Liver problems after Fipronil + S-methoprene (Frontline Plus) 68 reports · 2.3% of its reports
Liver problems after Flumethrin + Imidacloprid (Seresto) 47 reports · 2.1% of its reports
Liver problems after Fipronil 53 reports · 3.8% of its reports
Liver problems after Lufenuron 53 reports · 5.2% of its reports
Liver problems after Imidacloprid + Permethrin + Pyriproxyfen 21 reports · 2.8% of its reports
Liver problems after Imidacloprid + Permethrin 24 reports · 5.1% of its reports

All reported side effects of Imidacloprid + Moxidectin in dogs · Medicines most reported with liver problems